Classes 1, 2, 3 BPJS Health Officially Abolished, Here Are the Latest Contributions
- President Joko Widodo officially abolished the class 1, 2, 3 system in the Health Social Security Administration (BPJS). Instead, BPJS will implement a Standard Inpatient Class (KRIS) system.
The abolition of the class system in BPJS Health is contained in Presidential Regulation (Perpres) Number 59 of 2024 concerning the Third Amendment to Presidential Regulation Number 82 of 2018 concerning Health Insurance. Through the decision issued on May 8 2024, Jokowi ordered every hospital collaborating with BPJS to implement the KRIS system no later than June 30 2025. With the implementation of KRIS, contributions for BPJS will also change. As is known, previously BPJS Health membership was divided into class 1, 2 and 3 categories.
These classes determine the fees that participants must pay every month. The class will also determine the inpatient class that will be accepted. The better the inpatient class, the greater the contribution that participants must pay each month. Meanwhile, changes to fees in the KRIS system are contained in Article 103B of Presidential Decree 59 of 2024. Paragraph 6 of Article 103B states that the Minister of Health will conduct an evaluation of the treatment room facilities in each hospital. The evaluation will be carried out in joint coordination with BPJS Health, the National Social Security Council, and the minister who handles government affairs in the financial sector.
Paragraph 7 of the same article then states that the results of the evaluation and coordination of treatment room facilities in inpatient services as referred to in paragraph (6) are the basis for determining benefits, rates and fees. Meanwhile, paragraph 8 of the article also states: "The determination of benefits, rates and contributions as referred to in paragraph (7) is determined no later than July 1, 2025."
New BPJS Health Rules, Get Ready for Class 3 Participants to Pay More Expensive Contributions
BPJS Health invites you to regularly pay JKN membership fees on time
– Care classes using BPJS Health will be abolished no later than June 30 2025. Later, the government will implement a Standard Inpatient Class (KRIS) system, meaning that all BPJS Health participants will receive relatively similar quality treatment rooms.
Responding to this, the Daily Executive of the Indonesian Consumers Foundation (YLKI), Agus Sujatno, said that Presidential Regulation Number 59 of 2024 concerning Health Insurance will impose a burden on people who use third class BPJS. Although up to now KRIS premiums or contributions have not been determined by the Government.
"Existing participants who are grouped in class 3 are forced to move up a class. Of course, the consequences of fees also have the potential to increase," said Agus when contacted by VIVA Business Monday, May 13 2024.
Agus said, meanwhile, existing BPJS Health participants who are currently registered in class one must voluntarily downgrade and adjust their KRIS. According to him, if a BPJS participant objects to the treatment room they receive, then the participant is allowed to move up to VIP class.
BPJS health Photo : vstory
"Well, ex-class 1 patients who don't want to be hospitalized in the same room, are welcome to go up to the hospital's VIP class. Of course, with the consequence of paying the difference in costs, becoming a general patient, or being covered by private insurance (if you have one), " he explained.
Thus, YLKI suspects that the KRIS currently signed by President Joko Widodo (Jokowi) was initiated to accommodate commercial insurance interests.
"Thus, it is reasonable to suspect that this standard class was initiated to accommodate commercial insurance interests. Hospitals will compete to increase the number of VIP rooms, to accommodate JKN participants who do not want to use the standard class," he explained.
Apart from that, Agus said that with this rule, hospitals are obliged to allocate a minimum of 60 percent as a standard inpatient class for government hospitals, and 40 percent for private hospitals. This means that hospitals must immediately improve or renovate to comply with the mandate of the Presidential Decree.
"It is not easy for hospitals, especially private ones, to change room sets to suit standard inpatient classes," he stressed.
On the other hand, Agus believes that this change in space is also important for standardization. According to him, the supervisory team was appointed to carry out a credentialing process to adjust standard classrooms.
"There should not be a standard inpatient class program but the infrastructure differs from one hospital to another," he said.
Agus is of the view that this phenomenon also has the potential to create hospital clusters. In this case, hospitals that accept BPJS will be considered second class hospitals, while hospitals that do not cooperate will be considered premium hospitals.
Agus said that the readiness of human resources to implement service standards is also needed. Due to the large area coverage in Indonesia, there is a problem of unequal distribution of experts/specialist doctors in each hospital.
BPJS Health Photo : vstory
"Especially in 3T areas. In other words, when implementing KRIS, it must also be accompanied by the same standard services, which include medical personnel, medicines and equipment facilities," he explained.
Agus continued, actually currently what the consumer community needs is standardization of services, not standardization of inpatient classes.
"By standardizing services, there are no allegations of gaps in treatment that many patients have been worried about," he added.
"Therefore, it is reasonable to suspect that this standard class was initiated to accommodate commercial insurance interests. Hospitals will compete to increase the number of VIP rooms, to accommodate JKN participants who do not want to use the standard class," he explained.
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